Type and Timing of Childhood Maltreatment and the Impact on Trajectories of Borderline Personality Disorder

Abstract

Borderline personality disorder (BPD) is a chronic and debilitating condition characterized by affective instability, impulsivity, and interpersonal difficulties. Although childhood maltreatment is a known risk factor for BPD, few studies have examined the combined impact of the type (sexual or physical) and timing (pre-elementary, elementary, or high school) of maltreatment on the longitudinal development of BPD symptoms. This gap in knowledge was addressed by analyzing trajectories of BPD symptoms across early adulthood (ages 20 to 26) using data from the McMaster Teen Study, a longitudinal cohort of 701 participants. A two-class latent trajectory model revealed low stable (78%) and moderate stable (22%) symptom groups. Hierarchical logistic regressions indicated that both sexual and physical maltreatment were significant predictors of moderate BPD symptom trajectories, with sexual maltreatment demonstrating a stronger effect. Additionally, maltreatment experienced during pre-elementary and elementary school significantly predicted categorization into the moderate stable BPD symptom trajectory, while high school maltreatment did not. Gender and bullying victimization were also significant covariates, with women more likely to fall into the moderate stable group. These findings emphasize the importance of early prevention and intervention efforts, specifically, targeting children exposed to early-life adversity, and highlight developmental timing as a key factor in the etiology of BPD.